Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[The effects of conscious sedation by propofol on respiration during abdominal hysterectomy under spinal anesthesia].
The effects of conscious sedation by propofol on respiration were studied in 28 patients undergoing abdominal hysterectomy under spinal anesthesia. The patients were randomly assigned to receive conscious sedation by propofol (Group P, n = 20) or no sedation (Group C, n = 8). After a satisfactory level of analgesia had been achieved, a loading dose of propofol, 0.2 mg.kg-1 was administered every minute in Group P until patients exhibited spontaneous eye closure or nystagmus. ⋯ Compared with Group C, the respiratory depression was less in Group P; SpO2 was significantly higher at 25 min after spinal tap and PETCO2 was significantly lower at 30 and 50 min after spinal tap in Group P. A score of patient satisfaction was significantly higher in Group P. Conscious sedation by propofol is a safe and useful supplement to spinal anesthesia for abdominal hysterectomy.
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Comparative Study Clinical Trial
[The techniques to identify the epidural space do not influence the success rate in combined spinal-epidural anesthesia: a comparison between loss-of-resistance and hanging-drop].
The hanging-drop (HD) technique has been attributed to a negative epidural pressure induced by making a tent of the dura by the Tuohy needle. We, therefore, hypothesized that the HD technique would result in more successful intrathecal placement of the spinal needle in combined spinal-epidural anesthesia (CSEA) compared with the loss-of-resistance (LR). Seventy patients received CSEA using the needle-through-needle method with a spinal needle extending 9 mm beyond the Tuohy needle. ⋯ Failure to obtain CSF after 3 attempts was not significantly different between the two techniques; 26% and 31% in HD and LR, respectively. In conclusion, there was no advantage of the HD technique for obtaining CSF in CESA compared with the LR. It seems that spinal needle length beyond the Tuohy needle should be more than 9 mm.
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Case Reports
[Anesthetic management of a hyper-obese patient by target-controlled infusion (TCI) of propofol and fentanyl].
We gave total intravenous anesthesia to an over-100% hyper-obese patient using target-controlled infusion (TCI) of propofol and fentanyl. To keep him asleep, we maintained his BIS in a range of 40 to 60 by adjusting the target concentration of propofol. ⋯ The relationship between BIS value and effect-site concentration of propofol was almost the same as that assessed in ordinary adults of a normal weight. We conclude that the estimated concentration of propofol is a good indicator of the effect of propofol and that TCI is a useful technique in obese patients as well as in ordinary adults.
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We present a case of a 46-year-old female patient with systemic lupus erythematosus who developed herpes zoster of the right eighth cervical nerve. Her whole right forearm, hand and the first through fifth fingers were coated with some gel and protected against pain. ⋯ Reduction of pain and edema as well as improvement in mobility of each joint of her right upper extremity was observed. We suspect that SGB, continuous cervical epidural block and ulnar nerve block are effective and useful alternative treatments in a patient with PHN associated with CRPS of the eighth cervical nerve.
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Historical Article
[New study on the history of anesthesiology (8)--Etymological consideration on a Japanese word "Masui"].
The author briefly describes etymology of a Japanese word "Masui" ([symbol: see text]) and discusses why this word has not been correctly understood by lay people as well as Japanese anesthesiologists. The word "Masui" was coined by Seikei Sugita in 1850 when he translated Dutch edition of Schelesinger's monograph on ether anesthesia into Japanese. ⋯ The author thinks that one of the causes for this inadequate acceptance is that the correct Japanese words of "Masuika-gaku" and "Masuika-i" for Anesthesiology and Anesthesiologists were not coined and the incorrect words as "Masuigaku" and "Masui-i" have been used. Not a small number of Japanese anesthesiologists still employ the words "Masuigaku" and "Masui-i" without any special reasons.